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ICD-10 Speficicity

  1. Default ICD-10 Speficicity
    Medical Coding Books
    I've been looking over the ICD-10 codes this morning and the same question popped into mind. What is going to stop our doctors from documenting like they always have?

    For example, Otitis Media. I tell them that we need to know if it's left ear, right ear, or bilateral, but there's still a UNSPECIFIED code. In their mind, we can still code it. Another example is Colon Polyps. We can code it to cecum, apendix, sigmoid, ect., but again, there is still a code that says "Benign neoplasm of colon unspecified." or "Polyp of Colon".

    I've been told that insurance companies wont pay if there is an unspecified code, how can we verify this? If that's the case then I will by all means tell the doctors.

  2. #2
    Default Icd-10
    You cannot verify reimbursement as of yet. Everything I have read says that payors will reimburse ICD-10 as "budget neutral" until the bugs are worked out of the reimbursement systems...THEN they will flag codes for non payment, I am guessing. Physicians will need to review new codes and documentation requirements that are specific to their practice to that they are able to document for the new codes.
    Becky Stephenson, RN, CPC, CPC-H
    President/CEO VersaClaim, Inc.
    Austin, Texas

  3. Default
    Thanks. That is basically what I heard recenlty at a CMS Teleconfrence.

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